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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page s of B) <br /> XVII . FILL RISER SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A ❑ B ❑ C ❑ D ❑ <br /> A ❑ B ❑ C ❑ D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑ Industry Code or Engineering Standard (Specify) : <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Fill Riser Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> XVIII . COMMENTS <br /> Provide any additional comments here. <br /> NA-Section III - Fill Riser Sumps are present, but were not tested . <br /> I <br /> XIX. VENT / TRANSITION SUMP TESTING INFORMATION <br />' Manufacturer Identify Vent I Transition Sum ID from Section III for each Manufacturer <br /> Western Fiber lassNa or Pot a ❑x b ❑ c ❑ d ❑ <br /> Environ/Pol mer/Transition Sum a L1 Xc LJ d El <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify): <br /> ❑ Industry Code or Engineering Standard (Specify): <br /> Engineered Method (specify) : Caldwell Systems/Hydrostatic 30 Minutes <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Vent / Transition Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 7/5/2020 <br /> ICC Service Technician #5246802- UT 3/21 /2021 <br /> Underground Storage Tank Tester License #90- 1120 12/31 /2022 <br /> XX. COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />